Provider Demographics
NPI:1811205537
Name:SCHMELZLE-KRAEMER, JILLIAN MARIE (MD)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:MARIE
Last Name:SCHMELZLE-KRAEMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26W254 KIOWA LN
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-8914
Mailing Address - Country:US
Mailing Address - Phone:630-544-0647
Mailing Address - Fax:
Practice Address - Street 1:MACNEAL HOSPITAL
Practice Address - Street 2:3249 OAK PARK AVENUE
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-3429
Practice Address - Country:US
Practice Address - Phone:708-783-9100
Practice Address - Fax:708-783-2188
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036131739207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036131739Medicaid
ILF400169078Medicare PIN